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Grey matter injury after cardiac arrest: morphometric changes, effects of inhaled xenon, and associations with brain-enriched biomarkers - Xe-Hypotheca, A Randomized controlled trial

Year: 2026
Type: dissertation
Abstract: Out-of-hospital cardiac arrest (OHCA) is a major cause of death and long-term neurological disability. Only a minority of patients survive, and many develop a hypoxic-ischemic brain injury (HIBI). Subsequent to the initial cessation of blood flow, the secondary damage occurring after reperfusion worsens the brain injury and represents a potential target for treatment. Until now, the only clinically tested therapeutic approach has been targeted temperature management (TTM). Preclinical studies indicate that xenon gas has neuroprotective properties. While the Xe Hypotheca trial evaluated the neuroprotective effect of xenon on the brain white matter, this study examined xenon`s neuroprotective effects on the grey matter. Patients from the Xe-Hypotheca trial underwent two MRI scans on days 2 and 10 after OHCA. Grey matter changes were analysed using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). Associations between MRI findings and four different blood biomarkers of brain injury (GFAP, NfL, NSE, t-tau) were also assessed. A total of 45 patients were included in the VBM analyses, and DTI data were available from 96 patients. The main finding was that xenon combined with TTM was associated with a better preservation of the grey matter volume when compared with hypothermia alone. Increases in NfL and t-tau levels correlated with the reduction in the volume of the grey matter. However, diffusivity changes did not show consistent associations with biomarkers. In conclusion, inhaled xenon may reduce the secondary brain injury occurring after cardiac arrest. Two blood biomarkers, NfL and t-tau, appear to predict grey matter damage during the first week after OHCA.
Institution: University of Turku
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7220772364
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